Everyone who experiences migraine can reduce their likelihood of a migraine attack by avoiding meal-skipping. That’s because it causes blood sugar fluctuations and may result in a migraine attack, according to Brian M. Plato, D.O., headache medicine specialist and neurologist with Norton Neuroscience Institute.

A broad strategy includes eating regular small meals throughout the day, drinking about two to three quarts of water and avoiding preservatives and chemicals in your diet, according to Dr. Plato.

“Plan on eating more whole foods, sticking with a regular food schedule and getting plenty of water,” he said. “Moderate exercise three to five times a week, totaling about 150 minutes, can help.”

Common migraine trigger foods

Caffeine

Caffeine is in many over-the-counter migraine medications, but when consumed frequently it can lead to more headaches — rebound headaches and medication overuse headaches. Sudden caffeine withdrawal can increase headaches.

Generally, about 100 milligrams of caffeine daily shouldn’t cause an issue, according to Dr. Plato. Soda will have 30 to 50 milligrams, 6 ounces of coffee brewed at home would have about 103 milligrams, 6 ounces of home-brewed decaf has 2 milligrams, and 6 ounces of tea has 30 milligrams. A 16-ounce Pike Place Roast coffee from Starbucks has 310 milligrams.

Aged cheese

Aged cheese is often highlighted as a common trigger for migraine attacks. This is primarily due to the presence of tyramine, a compound that forms as proteins in cheese break down over time. Tyramine is known to trigger migraine headaches in sensitive individuals by affecting the blood vessels in the brain and potentially leading to headaches. For those who experience migraine, avoiding aged cheeses like blue cheese, cheddar and Parmesan could be beneficial in managing their condition and reducing the frequency of migraine episodes. By being cautious about consuming aged cheese, individuals may potentially prevent migraine headaches and alleviate some of the associated symptoms.
 

Alcohol (especially red wine)

When it comes to alcoholic beverages as headache triggers, red wine is a common culprit. Red wine is a known migraine trigger due to its high levels of tyramine, histamine and sulfites. These compounds can lead to blood vessel dilation and contribute to headache development in susceptible individuals. Also, preservatives like nitrates can have vasodilatory effects — flushing or warmth as blood vessels near the surface of the skin widen.

Those with migraine also may be more susceptible to hangovers. Dehydration from alcohol may trigger a migraine attack.

Small levels of alcohol may not necessarily increase the frequency of migraine attacks unless paired with an additional trigger, such as stress or sleep deprivation. For individuals sensitive to alcohol, moderation or avoidance is often recommended to help prevent migraine headaches.

Processed meats

Processed meats can trigger migraine due to their high levels of tyramine, as the compound can cause blood vessels to constrict and then expand, leading to the onset of a migraine headache. Additionally, processed meats often contain nitrates and nitrites, which are also considered common migraine triggers. These substances can lead to inflammation and potentially disrupt the delicate balance of neurotransmitters in the brain, contributing to migraine symptoms. For individuals prone to migraine symptoms, avoiding processed meats like pepperoni, salami, bacon, sausage and deli meats can be a key step in managing and reducing the frequency of migraine attacks.

Artificial sweeteners

Artificial sweeteners have been identified as potential triggers for migraine episodes in some individuals. Substances like aspartame, saccharin and sucralose, commonly used in diet sodas, processed foods and sugar-free products, may lead to headaches and migraine attacks in susceptible individuals. The exact mechanism by which artificial sweeteners trigger migraine is not fully understood, but it is believed to be linked to the disruption of neurotransmitters, changes in blood flow or even the alteration of gut bacteria composition. For those prone to migraine headaches, monitoring and potentially reducing artificial sweetener consumption could be beneficial in managing migraine triggers.

Chocolate

Chocolate is labeled a migraine trigger by many, but there could be confusion between it and the craving of sweets that can precede a migraine.

“If you’re craving something sweet, eat some chocolate, and develop migraine — your natural thought is going to be, ‘Oh, I got this migraine attack because I ate chocolate,’ when actually, maybe the migraine attack was going to develop no matter what,” Dr. Plato said.

There may be some chemicals in chocolate that can lead to headache, but there’s no reason to throw away all the chocolate in the house right away.

Monosodium glutamate (MSG)

MSG is a common trigger. MSG occurs naturally in many foods, such as tomatoes and cheeses. It’s also among the food additives in processed food, snacks, salty foods, seasoning blends, frozen foods, processed meats and more to add an umami, or savory flavor.

Other food-related migraine triggers

Fasting

Breakthrough migraine attacks are more likely with fasting. Certain religious traditions involve fasting, and during these times the faithful are more likely to develop headaches. Additionally, work or school may limit the times some can eat, resulting in long periods of fasting, which also may trigger migraine attacks.

Gluten sensitivity

Those with a gluten sensitivity are more likely to have migraine headaches. Migraine is more prevalent in individuals who had celiac disease. A gluten-free diet may be appropriate for patients who have migraine and gastrointestinal symptoms such as bloating and diarrhea.

Tracking your migraine triggers

Maintaining a detailed headache diary that includes the timing of your meals and any subsequent migraine symptoms can help you manage symptoms and avoid triggers:

1. Jot down the specific foods you consumed, paying close attention to potential triggers like aged cheese, red wine, processed meat, artificial sweeteners and caffeine.
2. Record the severity and duration of each migraine episode, along with any associated symptoms such as nausea, sensitivity to light or aura.
3. Include information about your overall diet to identify patterns and pinpoint common triggers that may be exacerbating your migraine headaches.
   
   

Consistently tracking and logging your food intake and any migraine symptoms can help you better understand and manage your migraine triggers for improved relief and prevention. An elimination diet, where you remove potential trigger foods, then slowly reintroduce them while keeping a headache diary that tracks migraine symptoms, can help identify potential trigger foods. Focusing on consuming whole foods, including foods that help migraine, and reducing processed foods is a good starting point.

If you do experience migraine symptoms after eating certain foods, there are strategies for how to get rid of a headache at home. Consider consulting a health care professional or nutritionist for guidance on implementing an elimination diet to determine which foods could be causing you to experience migraine. A headache medicine specialist can provide additional options for the treatment and prevention of migraine.

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Understanding common headache pain

There are many varieties of headache, based on the cause and symptoms — and there are many ways to treat headaches.

“There are ways to prevent headache, and working with a headache specialist or your primary care physician can point you toward the best lifestyle modifications, preventive treatments and rescue treatments to manage the symptoms,” said Christopher P. Rhyne, M.D., headache medicine specialist with Norton Neuroscience Institute Headache Center. “If you find that headaches are ever inhibiting your ability to live your life the way you want to, make an appointment to see a headache specialist who can develop a treatment plan for you.”

Headaches manifest in different forms and can be a condition that is passed down through families or indicative of various underlying issues. A headache symptom can range from a typical dull ache to intense throbbing pain, causing discomfort that can vary in intensity and duration. Sensitivity to light and sound can accompany some headaches, making it challenging to engage in regular activities. Moreover, muscle tension in the neck and shoulders is a prevalent symptom associated with headaches, especially tension headaches and migraine.

Understanding common headache symptoms is key not only to managing the immediate discomfort but also identifying the type of headache, plus patterns or triggers that could help in preventing future headache episodes. By recognizing these symptoms, individuals can take proactive steps in addressing their headaches and improving their overall quality of life.

3 common types of headaches

1) Tension headaches are one of the common types of headaches that affect a significant number of adults. A tension headache typically begins gradually and is characterized by a persistent, dull-to-moderate pain that tends to be felt on both sides of the head. It can be caused by muscle tension in the head, neck or shoulders. When looking to get relief from tension headache pain, a key strategy involves reducing activities that may contribute to stress. Over-the-counter pain medications often are recommended as a first line of treatment for tension headaches. Incorporating relaxation practices into your daily routine also can be beneficial in easing the symptoms associated with tension headache pain. With a combination of stress-reduction techniques, appropriate medication use and relaxation methods, you may be able to address and manage tension headaches effectively to promote better overall well-being and headache relief.

2) Migraine is a neurological condition thattypically presents with moderate to severe throbbing or pounding head pain, sensitivity to light and sound, nausea, or vomiting, as well as changes in appetite. Women tend to be more susceptible to migraine than men, and there is often a genetic component involved, with a tendency for migraine to run in families. A migraine is not just a headache; a migraine attack can last up to 72 hours. If you experience migraine attacks that impact your life, you should seek guidance from your primary care provider or headache specialist. They can help assess your symptoms and establish a treatment plan. Identifying and addressing triggers, such as certain foods, stress or hormonal changes, may play a key role in managing and easing migraine symptoms effectively. Migraine medications for prevention and acute rescue may be prescribed for you. Remember, effective management of migraine often involves a combination of lifestyle adjustments, medication and sometimes alternative therapies, all tailored to suit your individual needs and experiences.

3) Cluster headaches, often described as excruciatingly painful, have a distinctive pattern of occurrence. These intense headaches typically manifest behind one eye, causing sharp and piercing pain that is debilitating. These attacks tend to last for 30 to 90 minutes and then fully resolve. Unlike other types of headaches, cluster headaches tend to strike multiple times a day, often clustering together during certain time periods — which is where they get their name. Cluster headache tends to impact males more than females and can have serious consequences due to the level of pain associated with the cluster attacks.

Identifying triggers is crucial in managing cluster headaches, and common culprits include foods rich in nitrates like bacon and processed meats. Additionally, tobacco use has been strongly linked to triggering cluster headaches, making it important for those who experience these headaches to consider lifestyle factors in their quest for relief. Understanding these triggers can go a long way in effectively managing and reducing the frequency of cluster headaches. If you are concerned you might be dealing with cluster headaches, seek care from a doctor.

5 ways to get treat a headache

While there are dietary changes you can make to improve a headache condition, additional lifestyle choices can help reduce the onset of migraine attacks. Here are five effective strategies to help mitigate headache pain and encourage headache relief:

1. Prioritize sleep hygiene: Establish a consistent sleep schedule by going to bed and waking up at the same time daily. Engage in a calming pre-sleep routine like taking a warm shower, drinking a soothing decaffeinated beverage or practicing meditation. Aim for eight to nine hours of rest in a cool, dark environment to promote quality sleep and potentially reduce headache occurrences. 

2. Embrace regular exercise: Dedicate just 30 minutes, three times a week, to physical activity, as it can significantly decrease the severity of migraine. Exercise not only aids in managing a healthy weight and blood pressure but also contributes to overall well-being. 

3. Maintain regular eating habits: Ensure you consume balanced, nutritious meals regularly to support your body and potentially prevent headaches. Be mindful of food choices and avoid skipping meals, as fluctuations in blood sugar levels can trigger headaches. Stay cautious of food additives like MSG, and be moderate with your alcohol intake, as these also can be potential headache triggers. 

4. Stress management: Incorporate stress-relieving practices such as meditation, yoga or engaging in hobbies to reduce stress levels. Taking moments to focus on deep breathing and participating in activities that bring you joy can reduce stress and potentially alleviate headaches. 

5. Identify and steer clear of triggers: Familiarize yourself with common headache triggers by referencing resources such as the American Migraine Foundation. Understanding what factors can induce headaches for you personally and actively avoiding them whenever possible are key to managing and potentially preventing headache episodes.

Headache relief at home

Some home remedies can be useful for alleviating headaches, such as relaxation techniques like deep breathing or yoga. Additionally, gentle neck stretches and reducing screen time can help reduce tension or eyestrain that can contribute to headaches.

Although over-the-counter pain medication such as ibuprofen, acetaminophen, naproxen or aspirin can help reduce headache pain in the short term, it is not an adequate treatment for headache conditions. Relying on over-the-counter pain medications can lead to overuse if taken too often. This should be discussed with your primary care provider or headache specialist in order to better understand your headache condition. Your provider can offer a personalized treatment plan, which may include over-the-counter medications when necessary.

Finding relief from headaches

Now that you have some ideas for how to effectively get rid of a headache, it is time to implement strategies for pain relief. Common types of headaches include tension headaches, migraine headaches and cluster headaches. Headache treatment in adults is multifaceted, and there are different approaches to headache relief, including home remedies, natural remedies and headache management techniques. It is important to know how to identify headache symptoms, understand their underlying causes and explore various treatment options. To help manage and lessen your headache pain, reach out to your health care provider. They can provide insights to help improve your overall health and well-being or refer you to a headache specialist, if necessary.

The post Trying to figure out how to get rid of a headache? Treatment options can depend on many factors appeared first on Norton Healthcare.

“The change in barometric pressure may act as a triggering event for people who experience headaches and migraine,” said Brian M. Plato, D.O., neurologist and headache medicine specialist with Norton Neuroscience Institute. “In addition to barometric pressure changes, bright sunlight, extreme heat or cold, sun glare, high humidity, dry air, and windy or stormy weather also can have a significant impact.”

While studies have not found a direct link between weather changes and headache or migraine attacks, according to the American Migraine Foundation more than one-third of people who experience migraine claim weather changes have a noticeable impact on their symptoms. 

Barometric pressure and weather-related headache

One of the biggest triggers for weather-related migraine and headaches is barometric (also called atmospheric) pressure. A 2017 study established an association between atmospheric pressure and the amount of migraine pain a person experiences. Another study from 2019 shows how weather, pollution and barometric pressure can trigger headaches.

Dramatic weather swings usually cause changes in barometric pressure. A pressure difference between a person’s environment and the sinus cavities can increase the chance of headache and migraine. This pressure difference can lead to swollen sinuses, especially if the person already has congestion or blockage.

You may have noticed this pressure effect while flying. As a plane changes altitude during takeoff and the approach for landing, the air pressure changes and your ears may pop — or you may experience head or ear pain.

Other aspects of weather that may trigger migraine:

• Bright sunlight
• Extreme heat or cold
• Sun glare
• High humidity
• Dry air
• Windy or stormy weather

Tips for dealing with weather-related migraine or headaches

Dr. Plato recommends the following if you experience weather-related migraine:

• Monitor other headache triggers: Drink plenty of fluids to stay hydrated, get adequate rest, exercise and keep your stress under control.
• Have your medication handy: With the changing weather, it’s best to keep your medications with you 24/7. Should a headache or migraine emerge, you are prepared. This can include preventive medications that help ward off headaches as well as rescue medications for when one starts.
• Look at the forecast: You can predict when you’re likely to have a headache and take a preventive painkiller a day or two in advance.

“If a weather pattern is coming in that could trigger a migraine, take good care of yourself: Get extra sleep if you can, drink plenty of fluids and avoid any other migraine triggers,” Dr. Plato said. “You also can manage your schedule when the weather may be a problem for you; that way, you can be somewhere safe in case you become too fatigued or your migraine symptoms start.”

Highest level of headache expertise

Whatever the trigger for your headache or migraine pain, Norton Neuroscience Institute’s headache medicine team offers the highest level of care.

Two Norton Neuroscience Institute physicians are board certified by the United Council for Neurologic Subspecialties. Headache patients from Louisville, Southern Indiana and beyond seek the expertise of Dr. Plato and Jeffrey H. Frank, M.D., as well as the staff of nurse practitioners who have received advanced recognition with the “Certificate of Added Qualification” from the National Headache Foundation.

Treatment is offered for those experiencing:

• Migraine headache
• Chronic daily headache
• Cluster headache
• Analgesic rebound headache
• Cervicogenic headache
• Menstrual-associated headache
• Tension headache
• Post-concussive/post-traumatic headache

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Nearly 1 in 5 women have migraine three times the rate for men. In the United States alone, 28 million women experience migraine.

There are two types of migraine: with or without aura.

Migraine with aura or MA is linked to a higher risk for ischemic stroke and heart attack. An ischemic stroke is caused by a blood clot in the brain. Hemorrhagic stroke, the other major type of stroke, is caused by a leaking blood vessel.

Migraine aura – flashes of light, blind spots or other changes in vision – typically precedes the headache pain. Migraine aura symptoms usually strike less than an hour before migraine’s intense head pain, nausea and heightened sensory sensitivity.

Migraine without aura does not seem to pose the higher stroke or heart attack risk that migraine with aura does. Most people with migraine do not have aura. Some people get both types of migraine.

Studies of women with MA attacks found the risk for stroke is independent of typical heart disease risk factors like age, diabetes and high blood pressure. Research looking at data from a number of studies found migraine is associated with a 1.5-fold increased ischemic stroke risk.

The combination of smoking and MA significantly increases the risk of having a stroke. Oral contraceptive use increases the risk even more.

Women who smoke and have migraine with aura should avoid oral contraceptives that contain estrogen, according to Dr. Plato, because the combined risks from all three increase the risk of stroke significantly.

The link between migraine and heart disease does not mean migraine is the cause of a stroke or heart attack. According to Dr. Plato, the higher risk is likely the result of several factors. Possible contributors include:

• The use of nonsteroidal anti-inflammatory drugs (NSAIDs) to treat migraine
• Inflammation
• Issues with the lining of blood vessels
• Lifestyle factors related to migraine, including reduced physical activity
• Genetics
• A common condition called patent foramen ovale, a hole between the left and right upper chambers of the heart
• Increased risk for a tear in an artery in the neck

An ischemic stroke is caused by a plaque buildup on the wall of a blood vessel breaking off and forming a clot that blocks blood flow to the brain. Cardiovascular disease also can contribute to a heart attack as the plaque blocks blood flow to the heart muscle.

For some, stroke symptoms and a migraine attack may seem similar. However, they are very different conditions. While stroke is caused by interrupted blood flow to the brain, migraine is thought to have more to do with chemical compounds and hormones. Rarely, a migraine attack appears to be associated with an ischemic stroke (migrainous stroke or migrainous infarction). 

Dr. Plato’s advice to patients is to work on lifestyle changes that decrease stroke and heart attack risks, including regular aerobic (cardiovascular) exercise, a healthy diet and not smoking.

Since the frequency of migraine aura attacks appears to be associated with higher cardiovascular risk, migraine preventive treatment might be beneficial, according to Dr. Plato.

Younger women shouldn’t be overly concerned about the migraine with aura stroke risk or heart attack. For women under 50, even those who have MA, the odds of having a stroke is lower than being struck by lightning.

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“I was sitting at home on the couch, and I was so nauseous I couldn’t even get up,” Glenda said.

The sudden pain was so intense, even her cocker spaniel, Katie, could pick up on it, licking Glenda’s head in an attempt to alleviate the pain for her.

That was 2005, and the pain would become part of Glenda’s reality.

“It is 10 times worse than a regular headache,” Glenda said. “[For] a headache, you can take something over-the-counter, and typically that helps. This is the worst thing. I don’t even wish it on my worst enemy. If I could put it on a scale of 1 to 10, it would be a 13.”

Glenda eventually was diagnosed with two types of headaches — the traditional migraine and occipital neuralgia, a condition that occurs when the occipital nerves, that run through the scalp, become inflamed. It causes headaches that feel like severe piercing, throbbing or shock-like pain in the upper neck, back of the head or behind the ears. For Glenda, they would flip on like a light switch.

“It’s more like electricity shooting up on the side of my head and affecting my vision,” Glenda said. “It only hurts when it’s shocking me, and then it stops hurting me when it stops shocking. It happens at the worst of times.”

She spent the next two decades trying to find her own cure, while her husband served in the military. He returned from duty as a combat-wounded veteran, experiencing post-traumatic headaches as a result of his military service.

At that point, Glenda put her health second as she assumed the role of her husband’s primary caregiver, helping him recover to the best of his ability. Her headaches got worse over time.

“It became debilitating for me,” Glenda said. “I finally determined that I needed to put myself first, kind of the old saying, ‘put the oxygen mask on before you take care of someone else.’”

‘I feel like I can live my life again’

Glenda was introduced to Botox as a treatment for migraine in 2010, shortly after the Food and Drug Administration approved the drug’s use. She learned about it during one of her husband’s appointments, but didn’t begin receiving the treatment until 12 years later, after she met Mandy J. Whitt, M.D., headache specialist with Norton Neuroscience Institute.

Since 2022, Glenda’s been receiving the Botox treatments every 12 weeks. The solution is injected 31 times in specific areas of the head and neck.

“It has been a game changer for me,” Glenda said. “I feel like I can live my life again.”

How Botox works for migraine

Botox, or onabotulinumtoxinA, is a neurotoxin that helps prevent migraine in a few ways. First, it acts as a muscle relaxer to stop spasms in different areas of the head, including the temporalis, frontalis and corrugator. It also works by inhibiting the transport of proteins that can cause migraine. Blocking this neurological process takes time, and the treatment can take up to nine months to be effective.

“Being a headache specialist, unfortunately when you get to me, you’ve generally tried a lot of oral medications, and you’re pretty miserable,” Dr. Whitt said

According to Dr. Whitt, many of her patients are experiencing headaches almost daily. She offers Botox to those who have failed multiple medications and for years.

“Most of the time the answer is, ‘Yes, I’ll try anything,’” she said.

Botox works particularly well in decreasing migraine symptoms. It is not a permanent cure, however, and usually wears off after 10 to 12 weeks as the headache-related proteins redevelop. That means it’s time to revisit the doctor.

Improving quality of life

“I would love for there to be a cure where I didn’t have to see them every three months, where it wasn’t wearing off,” Dr. Whitt said. “The fact that something’s helping, I love that we’ve improved the quality of life.”

For Glenda, that improved quality of live means that while she continues to care for her husband, she’s also gotten back to enjoying her hobbies. She’s restarted woodworking, gardening and canning, and her chicken coop looks better than ever.

She credits it all to Dr. Whitt, and her patient-first approach. “When you find a doctor who actually cares about the patient and is willing to try anything and everything to get the right care for you, you want to stick with them,” Glenda said. “In my past, and I have 20 years of experience, I have been to doctors who have ignored my pains. So, when you walk right in, she is so warm and so friendly, and it’s a team effort with her.”

The post Botox treatment for migraine helps Louisville woman relieve 20 years of headaches appeared first on Norton Healthcare.

The pain would hit suddenly behind his right eye, last for roughly 72 hours and then begin to subside. Five to six months later, the headaches would return with a vengeance.

It was like clockwork, yet he couldn’t explain why.

“I started noticing a pattern, and it was a time-based pattern,” Kevin said.

But Kevin’s clock was broken, because it started to speed up.

Five to six months between headaches shrunk to three months. That number dwindled even further. Eventually, the 72-hour, behind-the-eye headaches would return every 32 to 36 days. The pain became debilitating. Kevin started documenting his symptoms religiously.

“People throw phrases around and say it’s life-changing, and it was,” Kevin said. “I could be in the middle of family vacation, a trip, some important birthday or anniversary — and when these things hit it just ruins whatever moment you’re in. And that part was difficult. It really was life-changing, because they would ruin my life for a period of time.”

Kevin tried his luck with several physicians. He was misdiagnosed with migraine and given medication for the suspected condition. Several treatments never relieved his symptoms. He was feeling like he would never find a legitimate answer.

Then, his sister-in-law suggested he talk to Mandy J. Whitt, M.D, headache specialist at Norton Neuroscience Institute.

“It was the first conversation,” Kevin said. “I’m explaining to her [how I feel], and I was almost just, sort of, not exasperated, but just going through it. And I’m telling her, ‘I’ve been marking a calendar because no one believes me, and I have these three-day stretches marked on my calendar going back a year and a half, and they’re on this frequency, and there are no triggers.’ And she then took over the conversation and started taking the words out of my mouth about what it felt like when they hit and how they acted, and I started getting this glimmer of hope like, ‘Yes!’”

Dr. Whitt listened to Kevin’s story and diagnosed him with cluster headache, a rare condition that affects just 1 in every 1,000 people. The condition is known to bring painful attacks over a period of time, so much so that they are sometimes called “suicide headaches.”

Dr. Whitt knew she had to act quickly, using the notes Kevin had been taking to craft her plan.

“My staff knows if it is a true cluster patient, we are not going to delay,” Dr. Whitt said. “We are trying to get them out of pain as soon as possible and get them taken care of. And so, I will throw everything I have at them as quickly as I can to get them out of that attack and get them back to functioning.”

Over the course of three years, she’s collaborated with Kevin to find the perfect treatment for him, eventually landing on the drug Emgality, a monoclonal antibody treatment that had drastic and life-changing results.

“She was the first physician who really listened to what was going on,” Kevin said. “She just pulled out all the stops. She said, ‘Look, we will do whatever it takes [to make you feel better].’ It was good because she partnered with me. [She said], ‘Here’s what we’re going to do and here’s how we’re going to attack it,’ and that partnership just meant the world to me, because I knew she was engaged. Just having that level of care and attention and partnership was invaluable.”

The medication has left him headache-free for roughly 18 months, a dramatic improvement from where he was just a few years ago.

With his headaches mostly behind him, Kevin was able to focus his attention on his latest hobby, woodworking. And he knew he had to craft something special for the person who gave him his life back. He made by hand a small rocking horse for Dr. Whitt’s newborn child, as a thank-you for her compassion and care.

“It’s more than [a toy] for me,” Kevin said. “I was trying to just show her how much I appreciated her commitment to figuring out what was going on with me.”

“Whenever I hear that I get somebody out of cluster, that itself is Christmas to me,” Dr. Whitt said. “And to hear that the attacks are less, my staff knows I cheer. I almost feel like I need a bell to ring. And then he brought me that beautiful rocking horse — that was the cherry on top.”

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For Evelyn McKinney, that time was in the middle of a rain-soaked afternoon in May.

Evelyn was braving the storm, driving to her appointment with Mandy J. Whitt, M.D, a headache specialist at Norton Neuroscience Institute. Evelyn had a splitting headache, while her GPS gave her the directions to the wrong office.

Now late for her appointment, Evelyn called Dr. Whitt, who calmly rerouted her and waited more than two hours for Evelyn to arrive.

When Evelyn got to the office, Dr. Whitt immediately noticed something was very wrong.

“My nurses were going, ‘Dr. Whitt, would you check her pulse again? We’re having a hard time seeing what her pulse is,’” Dr. Whitt said. “So I checked her pulse again, and I couldn’t actually feel her pulse.”

According to the readings, Evelyn’s heart rate was ranging from 32 to 37 beats per minute, roughly half the average heart rate. Concerned, Dr. Whitt told Evelyn she needed to go to the hospital — and offered to call her an ambulance. Evelyn declined an ambulance ride and said it would take too long for family to take her, either. She wanted to get back in her car and drive home.

“She was going to pass out,” Dr. Whitt said. “She was lightheaded; she was short of breath. She wasn’t going [to the hospital], you could tell.”

With no other options available, Dr. Whitt did what she believed was best for her patient. She grabbed an empty wheelchair and quickly wheeled Evelyn from her office, across the parking lot and into the emergency department at Norton Brownsboro Hospital.

“This is the art of practicing medicine,” Dr. Whitt said. “Any computer can tell you that she needed to go to the ER [emergency room], but convincing her and getting her to actually go there and get the care, that’s the human touch. And so, that’s what makes practicing medicine, practicing medicine. Even though cardiology is not my field of practice, I hope to never lose that touch. Patients come first.”

Evelyn was admitted and diagnosed with bradycardia, a slower-than-normal heart rate. Doctors kept her overnight and fitted her with a pacemaker to regulate her heartbeat. All the while, Dr. Whitt monitored her condition and progress.

“Thanks to Dr. Whitt’s dedication and holistic approach to caring for her patient, Evelyn’s life was saved,” said Sofya Kuznetsov, M.D., electrophysiologist with Norton Heart & Vascular Institute. “This event demonstrates how so many providers work together across all of Norton Healthcare for the benefit of the patient.”

“It just meant so much,” Evelyn said. “She just saved my life, and it just made me feel like she was the only one at the time who cared enough about me, who wanted me to get better — and that means a whole lot to me. And I just want to let her know how much it meant.”

It meant so much to Evelyn that she decided to repay the favor.

Roughly a month later, she returned to Norton Neuroscience Institute – Brownsboro, to surprise Dr. Whitt at her office with a small gift and a hug, a thank-you gesture for the special care Evelyn believes saved her life. “If she wasn’t [willing to bring me to the hospital], I would’ve went home, and I probably would’ve died,” Evelyn said. “I don’t know anybody who would take the time like she did. She made me feel like I was her family, and that means so much to me.”

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Symptoms include:

• Shooting, stabbing or throbbing pain at the base of the skull
• Pain that starts at the upper neck and spreads along the scalp on one or both sides of the head

Burning, throbbing or aching pain on the scalp, or the scalp becoming extremely sensitive to the touch (allodynia)

READ MORE: What to do if you have a painless lump on the side of your neck

Pain or uncomfortable sensations may be felt in the upper neck, back of the head, behind the eyes and ears (typically on one side of the head), scalp, or forehead.

Occipital neuralgia is caused by irritation of the occipital nerves, which may be a result of trauma (for example, whiplash) or inflammation, or it may be idiopathic.

Diagnosing and referring for occipital neuralgia

“With occipital neuralgia, it can be tricky to pinpoint the cause as it is often times multifactorial,” said Brian M. Plato, D.O., neurologist and headache medicine specialist with Norton Neuroscience Institute. “Often times, patients will have many overlapping migraine symptoms including light and sound sensitivity and nausea.”

There is no one test for occipital neuralgia. A physical exam and neurological exam are important, as is a thorough medical history.

There is no specific treatment for occipital neuralgia, and no treatments are specifically FDA approved for the condition. Treatments such as muscle relaxants or tricyclic antidepressants are the first line treatment. Occipital nerve blocks can also at times be effective although the duration of benefit varies significantly from patient to patient.

If nonsurgical interventions do not provide enough relief, surgical interventions may be considered; although these procedures can be more challenging to have consistently covered by insurances.

Read more: Pain in the front of your neck: When to worry

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Las personas pueden confundir un aneurisma con un dolor de cabeza tipo migraña, retrasando la atención médica y posiblemente llevando a un daño significativo. Es importante aprender las diferencias y qué hacer cuando los signos de un aneurisma están presentes.

Si usted experimenta un dolor de cabeza severo (algunos lo describen como el peor dolor de cabeza de su vida) y viene de repente, llame al 911.

Un aneurisma cerebral es un área abultada débil en una arteria en el cerebro. Esto es similar a un punto débil en el tubo interior de una llanta. Dado que la pared de un aneurisma es delgada y débil, el aneurisma se puede roturar. La rotura del aneurisma es una de las emergencias médicas más devastadoras. Resultando en el sangrado dentro del cerebro y puede causar daño cerebral significativo e incluso la muerte.

El dolor de un aneurisma cerebral que está sangrando a veces puede confundirse con un dolor de cabeza tipo migraña. Incorrectamente percibir un dolor de cabeza severo como migraña que eventualmente se resolverá por su cuenta puede retrasar el tratamiento y puede tener consecuencias desastrosas.

Por lo tanto, es muy importante aprender las diferencias y qué hacer si usted experimenta los signos de advertencia de un sangrado de un aneurisma cerebral.

Resumen de Síntomas de una Migraña

Según la National Headache Foundation (Fundación Nacional de Cefaleas), los síntomas de la migraña varían de persona en persona, pero a continuación se encuentran las más comunes:

• Dolor de cabeza recurrente, durando de cuatro a 72 horas
• Dolor moderado a severo de un lado y pulsante
• Habilidad reducida para funcionar
• Náusea y/o vómito
• Sensibilidad a la luz
• Sensibilidad al ruido

Otros síntomas menos comunes de las migrañas pueden incluir sudoraciones o manos heladas, diarrea, color de la piel pálida y sensibilidad del cuero cabelludo, o dolor al tacto o presión (tal como una cadena tocando la piel, el cepillarse el pelo o afeitarse).

Resumen de Síntomas de Aneurisma

Para entender cómo la experiencia de un aneurisma cerebral roturado es diferente de una migraña, aquí están los síntomas, según la Brain Aneurysm Foundation (Fundación de Aneurisma Cerebral):

• Dolor de cabeza repentino y severo, usualmente descrito como “el peor dolor de cabeza de mi vida”
• Náusea/vómito
• Cuello rígido
• Visión borrosa o doble
• Sensibilidad a la luz
• Convulsiones
• Párpado caído
• Una pupila dilatada
• Dolor arriba y detrás del ojo
• Pérdida de la conciencia
• Confusión
• Debilidad y/o entumecimiento

Diferencias Importantes Entre los Síntomas de una Migraña y Aneurisma

Hay definitivamente cierto cruce entre los síntomas de las migrañas y un aneurisma cerebral roturado. Los síntomas tal como náusea y vómito, visión borrosa o doble y sensibilidad a la luz ocurren en ambas condiciones.

Éstas son, sin embargo, algunas diferencias importantes. El dolor de un aneurisma cerebral roturado es usualmente descrito como el peor dolor de cabeza de la vida de una persona. El dolor viene más repentinamente y más severo que cualquier otro previo dolor de cabeza o migraña.

En contraste, los dolores de cabeza tipo migraña usualmente vienen de forma gradual. Las migrañas usualmente causan un dolor de cabeza palpitante o una sensación pulsante en un lado de la cabeza. Estos pueden incluir un aura, lo cual es usualmente un signo de advertencia que la migraña está a punto de empezar. Las auras pueden incluir perturbaciones visuales o destellos de luz.

“Los doctores pueden encontrar un aneurisma sin roturar dado que un paciente se presenta con un dolor de cabeza sin relacionar, o después de un trama en la cabeza, llevando a que el doctor ordene una TC [escaneo de tomografía computarizada] o un RM [escaneo de resonancia magnética],” dice Shervin R. Dashti, M.D., Ph.D., neurocirujano con Norton Neuroscience Institute.

El tipo y el tamaño del aneurisma y cualquier factor de riesgo determina qué tan peligroso es un aneurisma en particular. Los aneurismas cerebrales roturados siempre requieren un tratamiento de emergencia. Con un aneurisma no roturado, solo aquellos que se encuentran en alto riesgo de rotura son tratados.

Tratamiento de Aneurisma

El tratamiento usualmente involucra métodos mínimamente invasivos para poder ‘enhebrar’ un catéter especial desde el abrazo del paciente, a través de la arteria radial hasta las arterias del cerebro y hasta el saco del aneurisma, según el Dr. Dashti. El método permite que el doctor bloquee el aneurisma desde adentro.

Ocasionalmente, puede ser necesario de abrir quirúrgicamente el cráneo y colocar un clip de titanio a lo largo del cuello del aneurisma para tratarlo.

Cualquiera de los dos procedimientos tiene la intención de prevenir que el aneurisma vuelva a sangrar o de causar más daño cerebral.

En Norton Brownsboro Hospital, los neurocirujanos endovasculares y cerebrovasculares entrenados por un Centro Integral de Accidentes Cerebrovasculares realizan más de 150 tratamientos de aneurismas cada año.

Si sus dolores de cabeza o migrañas no son repentinos y severamente terribles, hable con su proveedor de cuidado primario o aprenda más sobre nuestros especialistas en dolores de cabeza certificados por la junta.

The post Migraña vs. aneurisma: Las diferencias y los peligros appeared first on Norton Healthcare.

The following year, Katie began having seizures. Dr. Puri diagnosed her with epilepsy, unrelated to POTS. While he was able to control her seizures with medication, she wasn’t completely seizure-free.

“It was difficult being diagnosed with two medical conditions, especially at that age,” Katie said.

Throughout college and her early 20s, Katie had such faith in Dr. Puri that she continued her care in Louisville and “graduated” to seeing the adult providers at Norton Neuroscience Institute. In 2012, she had a vagus nerve stimulator (VNS) implanted by David A. Sun, M.D., Ph.D., neurosurgeon. This device sends pulses of electrical energy through the vagus nerve to the brain to help prevent seizures.

People with epilepsy are prone to migraine, and Katie was no different. Before her epilepsy surgery, Katie had been experiencing migraine attacks that eventually put a stop to her world.

“I was living with more headache days than not a month,” Katie said. “I found myself having to take life day by day again.”

‘Bring her home. I know someone who can help’

By the time her headaches were so frequent, Katie had moved out of state. Making the drive to Louisville for care while a migraine attack could strike at any moment wasn’t realistic. She sought help from a neurologist near her.

“The neurologist said that because of my other medical issues, there was nothing he could do and relegated me to an emergency room pain protocol,” she said. “I wanted a treatment plan and a solution, not painkillers.”

During one particularly terrible migraine attack, Katie’s parents called Dr. Puri from the hospital in desperation.

“He told my parents, ‘You need to bring her home. I know someone who can help,’” Katie said.

Dr. Puri referred her to Brian M. Plato, D.O., headache neurologist with Norton Neuroscience Institute. At her first appointment, Dr. Plato offered her a solution-oriented approach to migraine management and a treatment plan that didn’t include narcotics.

“Dr. Plato gave me hope that I wasn’t sentenced to a life with debilitating migraine attacks,” Katie said.

Married and back in Louisville, Katie gets team-based care; her ‘health has never been better’

Dr. Plato also worked closely with Katie’s other Norton Neuroscience Institute neurologists to ensure he was up to date on Katie’s overall health.

“Katie’s journey is the perfect example of our team approach at Norton Neuroscience Institute, where patients can see the specialist best suited for each phase of their care,” Dr. Plato said. “I can focus on the most up-to-date migraine treatment options for Katie, knowing that another trusted team member is simultaneously providing the most up-to-date care for her epilepsy. Each of us works together with the singular goal of making our patients’ lives better.”

Fortunately in better health, Katie and her husband, Ross Deppe, M.D., moved to Atlanta, Georgia, where he completed his residency and fellowship training. Katie never considered establishing care with a neurologist in her new city. Instead, she made a trip to see Dr. Plato every three months because, to her, the trust she had in him was worth it.

Today, the trip is much more convenient. When she and Ross were deciding where he would practice medicine after his training, the place that gave Katie her life back felt like the right fit to start their next chapter. He now is a physician with Norton Gastroenterology Consultants of Louisville.

But that’s not the end of Katie’s full circle of care. She now is a patient of Norton Neuroscience Institute epileptologist Ambica M. Tumkur, M.D., and is happy to report that she has not had a seizure since getting the VNS.

“My health has never been better,” Katie said. “Dr. Plato and all of my Norton doctors understood that quality of life is just as important as treatment. They worked to find that balance and gave me my life back. I am forever grateful.”

The post Never felt better: Louisville native returns and gets epilepsy and migraine team care appeared first on Norton Healthcare.